2008 Annual Report

Washburn County Health Department

2008 Annual Report

Washburn County Health Department, 222 Oak Street, Spooner, WI 54801

Monday - Friday: 8am - 4:30pm

Phone: 715-635-4400 Fax 715-635-4416

health@co.washburn.wi.us

Public Health has served Washburn County for 72 years. Our purpose has remained unchanged; to protect and promote the health and safety of the citizens of Washburn County. Our name and location has changed over the years, and our services continue to evolve to meet the changing health needs of our community.

As private providers expand services, the Health Department is committed to developing and exploring new unaddressed areas of health needs. We have expanded services over the years in compliance with state requirements.

Public Health Emergency planning is a new responsibility added to our programming. We have worked with local private providers and emergency government agencies to develop county-wide plans in the event of a disease outbreak. Pandemic Influenza education and planning has been a priority. We are part of the Western Regional Partnership for Public Health Preparedness. We have developed regional plans to ensure uniform comprehensive response. Plans are exercised and evaluated annually.

Some basic Public Health concerns continue to this day. Communicable disease investigation and control is ongoing. Childhood lead screening and immunization education, monitoring and delivery are a priority. Access to health care is addressed by offering BadgerCare+ Express Enrollment for pregnant women and children, reproductive health services for uninsured and underinsured women, and breast and cervical cancer screening and treatment assistance for uninsured and underinsured women.

We continue to promote healthy families by providing WIC services, infant care education, breastfeeding classes, car seat inspections, and school vision and hearing screening. Tobacco vendor inspections keep tobacco away from Washburn County children.

All of these services are in response to the state Healthiest Wisconsin 2010 Health Plan and the 2005 Washburn County Community Health Assessment. Washburn County Health Department continues to serve the approximate 17,000 citizens with quality programming and dedicated, competent, experienced staff.

Health Department Staff

Lori Bina, BS, MS, APSW

Health and Human Services Director/Health Officer

Jerri Pederson, RN, BSN

Public Health Supervisor

Public Health Nurses

Dianna Stumph, RN, BSN

Lead Public Health Nurse

Tim Nickell, RN, BSN

Public Health Nurse

Cheri Nickell, RN, BSN

Public Health Nurse

Amber Anderson RN, BSN

Public Health Nurse

Support Staff

Chelsea Paffel

Public Health Administrative Assistant

Jan Rath

Administrative Assistant

WIC Staff

Kim Nipe

WIC Coordinator

Julie Luedtke, RD, CD

Registered Dietitian

A special thank you to our Professional Volunteer Advisors for their continued belief and support in public health programming:

Dr. Beverly Bohac, MD

Medical Advisor

Dr. Jeffery Dunham, MD

Jail Medical Advisor

Dr. Gary Sloniker, DVM

Veterinary Advisor

Rabies Control

Wisconsin Statute 254 requires that the Health Department investigate all animal bites/exposures involving humans. Public Health Nurses provide education regarding the need for medical treatment and animal quarantine or humane euthanization.

Forty-seven animal bites/exposures were reported and investigated in 2008.

HIV Testing & Partner Referral Program

We provide anonymous and confidential HIV counseling, education, testing, and referral services under Wisconsin Statute 252.

The Partner Referral Program supports HIV positive clients in notifying partners for testing and counseling.

Children with Special Health Care Needs (CSHCN)

Washburn County Health Department provides case management services to parents with children from birth to 21 years of age who have special health care needs.

Fifteen Children with Special Health Care Needs received support from Washburn County Health Department in 2008.

Tuberculosis Testing/Surveillance

Tuberculosis (TB) skin tests are provided to community members and jail inmates. Tuberculosis case surveillance is state mandated per Wisconsin Statutes 252. Sixty-seven TB tests were completed in 2008.

Immunizations

As part of Wisconsin Statute Chapter 252, the Washburn County Health Department provides vaccinations to children and adults to prevent communicable diseases. We offer all recommended immunizations for children 0-18 years and limited adult immunizations. In 2008, Washburn County Health Department provided 500 childhood and 40 adult immunizations.

In addition, through electronic monitoring of records and monthly reminders, 86% of 2 year olds met immunization requirements in 2008. This exceeded our goal of 83%.

A walk-in immunization clinic is available on the first Wednesday of every month from 8am to 5pm and daily by appointment.

Communicable Disease Control & Prevention:

Wisconsin Statute 252 requires that local hospitals and clinics report communicable diseases to the local health department for investigation and surveillance.

We track communicable disease through a channel of communications at the local, state and regional levels between public health, private physicians, hospitals, and labs. This communication channel allows for prompt investigation of possible outbreaks, unusual situations, and to implement control measures thus minimizing further transmission of disease to others.

In 2008, Washburn County Health Department received 138 communicable disease reports such as Cryptosporidium, Hepatitis C, and Lyme disease. Preventing the spread of communicable disease remains a Public Health priority.

Reportable Diseases in Washburn County

Disease	2003	2004	2005	2006	2007	2008
Babeosis	0	1	0	2	2	1
Blastomycosis	0	1	2	1	0	0
Camphlobactor	1	5	5	3	3	1
Chlamydia	29	15	22	9	15	15
Clostriduim	0	0	0	2	0	0
Coccoduodmycosis	0	0	1	0	0	0
Cryptosporidium	2	0	0	2	1	3
Desert Fever	0	0	0	1	0	0
ECO 157	7	0	2	1	1	0
Ehrlichiosis	9	13	26	16	14	17
Genital Herpes	2	3	3	4	4	1
Giardia	1	5	2	0	1	2
Gonorrhea	1	1	4	0	2	2
Hepatitis A	0	0	0	0	1	0
Hepatitis B	0	1	0	1	2	0
HepatitisC	7	3	6	12	6	4
HIV	3	0	0	0	0	0
Influenza	8	0	0	2	6	0
Legionnaire's	0	2	1	0	0	0
Lyme's	58	66	67	67	72	73
Meningitis - Bacterial	0	1	0	0	0	1
Meningitis - Viral	1	0	1	0	0	1
Mycobacterium (non-Tb)	0	0	0	3	2	1
Norovirus	0	0	1	7	0	4
Pertussis	1	4	0	0	0	0
Salmonella	0	3	9	4	8	5
Shigella	0	0	0	0	0	0
Strep B	3	1	0	2	2	4
Tuberculosis	0	0	0	0	0	1
Varicella	NR	NR	NR	NR	NR	2
TOTALS	133	125	152	139	144	138

Reproductive Health Services

The Washburn County Reproductive Health Program provides services through the Maternal Child Health block grant, per Wisconsin Statutes 252 & 253. The program provides education, health assessment, and screening on a sliding fee scale.

Services include:

Education, counseling, and contraceptive supplies
Sexually transmitted infection risk assessment, counseling, education and testing; with referral for treatment
Medical Assistance Family Planning Presumptive Eligibility and Waiver enrollment/re-enrollment
Pregnancy risk assessment, counseling, testing, and referral
Medical Assistance Healthy Start Presumptive Eligibility enrollment for Pregnant Women

In 2008, 279 clients received contraceptive services. Forty-four clients received pregnancy test services.

WIC (Women, Infants, Children) Program

Under Wisconsin State Statute 253, Washburn County Health Department provides the WIC Program. The WIC Program is the Special Supplemental Nutrition Program for Women, Infants, and Children. WIC helps income eligible pregnant and breastfeeding women, women who recently had a baby, and infants and children up to five years of age who are at health risk due to inadequate nutrition. The program improves pregnancy outcomes by providing or referring to support services necessary for full-term pregnancies; reduces infant mortality by reducing the incidence of low birth weight and provides infants and children with a healthy start in life by improving poor or inadequate diets while saving long-term medical costs.

WIC provides essential health and nutritional education to women during the prenatal period that extends throughout the life of the child.

An average of 437 women and children were enrolled in the Washburn County WIC Program in 2008.

Public Health Preparedness

Washburn County is prepared to respond to all emergencies with a detailed plan of action and a system of communication with community responders. This response includes detecting disease outbreaks; investigating to determine what the risks are to the public and who may have been exposed; informing the public and professionals of the specific disease threats and how to protect themselves and others; managing infected persons; isolating or quarantining affected individuals as appropriate; providing medications or vaccinations to people at risk in the population.

In 2008, Washburn County preparedness efforts included testing a number of performance measures set by the Centers for Disease Control and Prevention that helps to determine whether our agency is ready to respond rapidly to a public health emergency, as well as all public health staff meeting the nine core competencies that are identified in the Columbia Core Competencies for Public Health Workers.

2008 exercises and planning focused on community containment. A tabletop exercise with community partners tested the implementation of community containment measures such as isolation and quarantine, school closure or social distancing measures during a pandemic. Washburn County Health Department held a pandemic influenza vaccination exercise at the Shell Lake Public School in 2008. County employees and volunteers helped staff clinic stations. Functions were practiced, evaluated, and improved.

Wisconsin Well Woman Program (WWWP)

Under Wisconsin Statute 255, Washburn County Health Department offers at no charge breast and cervical cancer screening through local medical providers to income eligible, uninsured or underinsured women between the ages of 45 and 64 through the Wisconsin Well Woman Program.

In 2008, 129 women were enrolled. Seventy-three women received cervical screenings and 77 received mammograms.

Prenatal Care Coordination (PNCC)

Under Wisconsin Statute 253, we provide access to medical, social, educational and other services to pregnant women who are considered high risk for adverse pregnancy outcome through our Prenatal Care Coordination program. Although Prenatal Care Coordination is limited to those who receive Medicaid, Washburn County Health Department monitors all high risk pregnant women. The components of this program are outreach, physical and emotional assessments, care plan development, ongoing care coordination/case management, and health education and nutrition counseling.

In 2008, 14 high risk pregnant women were enrolled and received PNCC services.

Maternal Child Health (MCH) Program

In 2008, 155 births were recorded in Washburn County. Educational packets were mailed to the parents of all Washburn County newborns.

In 2008, 25 children ages birth through 8 years were properly positioned in a child car passenger seat by a Public Health Nurse certified as a Child Passenger Safety Technician. This is the second year we offered car seat inspections. Eight donated car seats were distributed to low income families that failed the car seat inspection.

Childhood Lead Testing

Washburn County Health Department provides childhood lead testing under State Statute 254. In 2008, 196 children received blood lead screening at WIC. The Centers for Disease Control defines lead poisoning as a blood lead level of 10 or greater. In Washburn County, no children screened had elevated levels in 2008.

There is no safe level of lead in the human body. Even very low levels of lead exposure can cause permanent brain damage and negatively affect health throughout the child’s life, especially those between 6 months and 6 years of age. Many lead hazards still exist in homes and the environment, including paint, vinyl mini-blinds, chalk, candlewicks and others. These hazards are commonly present during painting and remodeling of pre-1978 housing. All children should receive lead screening at ages 1 and 2.

Environmental Health

Under Wisconsin Statute 254, the Health Department is responsible for enforcing the Washburn County Environmental Nuisance Ordinance in collaboration with the Zoning Office.

Eleven investigations were conducted in 2008. Most complaints involved an accumulation of debris and/or unsafe, abandoned structures.

Coalition Memberships

Washburn County Health Department was an active member of the following coalitions in 2008:

Birth to Three Advisory Committee
Children Come First
Elder Abuse Prevention Coalition
Long Term Support (LTS)
Northern Lights Preparedness Consortium
Safe & Stable Families Coalition
School Nurses of Wisconsin (SNOW)
Washburn County Alcohol and Other Drug Abuse Committee (AODA)
Washburn County Child Safety Coaltion
Wisconsin Association of Local Boards of Health (WALDAB)
Wisconsin Family Planning/Reproductive Health Association (WFPRHA)

School Vision & Hearing Screening

Early screening provides an opportunity for intervention and treatment, enhancing educational outcomes.

The Health Department provides vision and hearing screening for early childhood and targeted grades at the Birchwood, Minong, and St. Francis schools.

Spooner and Shell Lake school nurses utilize Washburn County Health Department’s hearing and vision equipment to provide testing to their students. Results below are for students screened by Washburn County Health Department.

2008 Results:

Screened Referred

Vision 247 10

Hearing 183 1

Jail Health

Washburn County Health Department provides jail nursing services to inmates at the Washburn County Jail. Services include medication monitoring, some treatments, tuberculosis and sexually transmitted infection screening, and arranging for medical care.

Washburn County Public Health Nurses spent 696 hours providing jail nursing services in 2008.

Tobacco Control

Tobacco compliance monitoring is provided per Wisconsin Statute 255. Ninety-five tobacco compliance checks were completed in an effort to monitor vendor sales to minors. Three vendors sold tobacco products to our minors, resulting in citations issued by the Washburn County Sheriff’s Department. That is nearly a 50% decrease in sales to minors from 2007. Public Health tobacco control funding also supported anti-tobacco youth-to-youth training and programming support at two participating area schools.

BadgerCare +

In 2008, Washburn County Health Department became a BadgerCare + Express Enrollment site. This service allows eligible individuals to receive immediate, temporary health care coverage while awaiting certification from the appropriate Human Services Department.

We successfully enrolled 34 BadgerCare + applicants in 2008.

2008 Board of Health & Human Services Members

The Board of Health is defined in Public Health Statute 251.03. It consists of elected and appointed members. Appointed members are persons who demonstrate an interest in the field of public health.

2008 Annual Report

Washburn County Health Department